When health of a na­tion puts the pa­tient last

Just Words...

There has been deaf­en­ing back­ground noise over the doctors and nurses not want­ing to sign up for a Cyprus na­tional health ser­vice that will be free for all Cypri­ots whether rich or poor.

And there seems to lie the prob­lem in a scheme that treats ev­ery­one equally and as­pires to de­liver top qual­ity health­care free of charge at the point of ac­cess. It al­most sounds too good to be true, doesn’t it?

What, Cypri­ots given a choice on how they want their health­care de­liv­ered and hav­ing the op­tion to go pri­vate at no ex­tra cost or in­con­ve­nience – can this be for real?

Strange that an es­tab­lish­ment based on priv­i­lege, un­fair­ness, in­equal­ity and in­jus­tice would seek to pro­vide a sys­tem of univer­sal care where, the­o­ret­i­cally, the treat­ment you re­ceive doesn’t de­pend on your so­cial class or in­come sta­tus.

This is the type of so­cial re­form that the peo­ple should be wel­com­ing with open arms – no more than that, they should be de­mand­ing why this didn’t hap­pen yes­ter­day.

We are slowly be­gin­ning to re­alise why this didn’t hap­pen yes­ter­day be­cause too many peo­ple have much to lose. What would in­sur­ance firms do if com­pa­nies stop pay­ing for pri­vate med­i­cal cover be­cause the state started pro­vid­ing a func­tion­ing, high-qual­ity ser­vice?

It wouldn’t make sense for em­ploy­ers to pay a con­tri­bu­tion to the state, while also in­vest­ing in pri­vate med­i­cal in­sur­ance if the ser­vice avail­able is of the same stan­dard.

Un­for­tu­nately, Cyprus wasn’t built on equal­ity for all, but on the premise that the sys­tem can be loaded to work for the rich and pow­er­ful groups that con­trol eco­nomic and po­lit­i­cal power.

Ar­guably, the govern­ment is try­ing to give some­thing back by fix­ing a dys­func­tional health sys­tem that is fail­ing on many dif­fer­ent lev­els to de­liver the best pos­si­ble treat­ment. It is un­der pres­sure, un­der­staffed and un­der­funded.

Vis­it­ing an emer­gency ward or go­ing to see a doc­tor is not an out­come to be rel­ished, while step­ping in­side a state hospi­tal fills one with trep­i­da­tion and co­pi­ous amounts of self-doubt.

Based on personal ex­pe­ri­ence, I al­ways feel that peo­ple of a cer­tain age and dis­po­si­tion that go into hospi­tal will be lucky to come out the other side, it’s that kind of a lot­tery.

Cyprus has some good hos­pi­tals but most them are pri­vate, ef­fec­tively cre­at­ing a two-tier sys­tem where the poor, el­derly and low-in­come work­ers have to en­dure what is thrown at them – wait­ing lists, chaotic hospi­tal out­pa­tients, bro­ken equip­ment and ca­su­alty wards un­der pres­sure.

There is also a gen­eral at­ti­tude to­ward pa­tients who are treated more like a nui­sance or a num­ber to tick-off rather than some­one in need of re­spect and re­as­sur­ance.

It’s as if the sys­tem has drained the care out of health work­ers.

I’m sure if some­one both­ered to do the re­search, all kinds of un­savoury statis­tics to do with our state health­care sys­tem would shock us – like how many pa­tients die over the week­end due to a lack of staff on duty.

Nev­er­the­less, the re­cent de­bate about the na­tional health ser­vice has cen­tred around the doctors rather than how it will af­fect the pub­lic.

None of the doctors like the na­tional health ser­vice be­cause it will hurt their pock­ets and not give them the free­dom they now have to rake in the cash where the tax man can’t see.

This has even been sug­gested by Pres­i­dent Anas­tasi­ades who im­plied that tax eva­sion among pri­vate doctors was con­sid­er­able which is why they don’t want to be put un­der the mi­cro­scope with state con­tracts.

Doctors also ar­gue that the govern­ment isn’t spend­ing enough on the new na­tional health ser­vice, al­though I’m not sure where they want this money to be spent – most prob­a­bly on salaries and perks.

No­body de­nies that doctors and nurses de­serve to be well paid, but there does seem to be some union-type bully­boy tactics be­ing ap­plied by the med­i­cal as­so­ci­a­tion to whip its mem­bers into line.

Cypri­ots are also to blame for al­low­ing the health agenda to be hi­jacked into a row be­tween govern­ment and doctors when there is so much that needs to be put right, like men­tal health­care.

Would the doctors be­have in this way if there was pub­lic pres­sure for them to di­rectly con­trib­ute to im­prov­ing the na­tion’s health by dis­man­tling a sys­tem that dis­crim­i­nates be­tween the wealthy and the not so rich?

The govern­ment has also made a bad fist of pro­mot­ing a new dawn in Cyprus health­care by not ex­plain­ing why it is nec­es­sary and the ben­e­fits it will bring.

Strangely enough, op­po­si­tion party AKEL has not been wav­ing its flag of equal­ity in the health sec­tor for work­ing class fam­i­lies. Maybe the nurses and doctors have valid ar­gu­ments about the fea­si­bil­ity of the scheme, but for now, it just sounds like a power play by health pro­fes­sion­als to pro­tect what they hold; pa­tient con­cern ap­pears some­way down the agenda.

Sounds like the new sys­tem will end up like the old one with the pa­tient be­ing the elephant in the room.